Limits...
Peritumoral edema shown by MRI predicts poor clinical outcome in glioblastoma.

Wu CX, Lin GS, Lin ZX, Zhang JD, Liu SY, Zhou CF - World J Surg Oncol (2015)

Bottom Line: The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China. albert978@126.com.

ABSTRACT

Background: Magnetic resonance imaging (MRI) plays an irreplaceable role in the preoperative diagnosis of glioma, and its imaging features are the base of making treatment decisions in patients with glioma, but it is still controversial whether peritumoral edema shown by MRI from preoperative routine scans are associated with patient survival. The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.

Methods: A retrospective review of 87 patients with newly diagnosed supratentorial glioblastoma was performed using medical records and MRI data from routine scans. The Kaplan-Meier method and COX proportional hazard model were applied to evaluate the prognostic impact on overall survival of pretreatment MRI features (including peritumoral edema, edema shape, necrosis, cyst, enhancement, tumor crosses midline, edema crosses midline, and tumor size).

Results: In addition to patient age, Karnofsky performance status (KPS) and postoperative chemoradiotherapy, peritumoral edema extent and necrosis on preoperative MRI were independent prognostic indicator for poor survival. Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.

Conclusions: Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma. These features were easy to determine from routine MRI scans postoperatively and therefore could provide a certain instructive significance for clinical activities.

No MeSH data available.


Related in: MedlinePlus

Eveluation of PTE. A region of very bright T2-W signal surrounding the tumor, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema. (A) Minor edema (<1 cm) shown by T2-W MRI. (B) Major edema (>1 cm) shown by T2-W MRI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4358863&req=5

Fig1: Eveluation of PTE. A region of very bright T2-W signal surrounding the tumor, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema. (A) Minor edema (<1 cm) shown by T2-W MRI. (B) Major edema (>1 cm) shown by T2-W MRI.

Mentions: For all patients, preoperative MRI data from routine scans (1.5-T scanner) including T1-W, T2-W, and contrast-enhanced T1-W sequences were available. The unidimensional maximum diameter in centimeters was used for measuring tumor size on T1-W images; median tumor size was 5.0 cm (rang 2.3 to 9.9 cm). The region of very bright T2-W signal surrounding the tumor was defined as PTE, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema and was graded as follows [6]: minor (Figure 1A) and major (Figure 1B). According to the method of Hartmann [18], the morphological classification of PTE was performed on the base of T2-W images. Necrosis which was estimated on axial contrast-enhanced T1-W images [19] was determined when a region had high signal on T2-W images, but low signal on T1-W images, and had an irregular enhancing border on contrast-enhanced images. Cyst was defined as a rounded region which was low T1-W signal and very high T2-W signal matching cerebrospinal fluid (CSF) signal and had a thin, smooth, regular, and slightly enhancing or non-enhancing wall [10]. Contrast enhancement in tumor was grouped as no obvious (enhancement signal is less than the signal of fat) and obvious (enhancement signal is similar to that of fat). The specific classification of imaging features was listed in Table 1. According to the classification methods mentioned above, imaging data of all patients were analyzed independently by two experienced radiologists without knowledge of patient clinical information.Figure 1


Peritumoral edema shown by MRI predicts poor clinical outcome in glioblastoma.

Wu CX, Lin GS, Lin ZX, Zhang JD, Liu SY, Zhou CF - World J Surg Oncol (2015)

Eveluation of PTE. A region of very bright T2-W signal surrounding the tumor, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema. (A) Minor edema (<1 cm) shown by T2-W MRI. (B) Major edema (>1 cm) shown by T2-W MRI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358863&req=5

Fig1: Eveluation of PTE. A region of very bright T2-W signal surrounding the tumor, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema. (A) Minor edema (<1 cm) shown by T2-W MRI. (B) Major edema (>1 cm) shown by T2-W MRI.
Mentions: For all patients, preoperative MRI data from routine scans (1.5-T scanner) including T1-W, T2-W, and contrast-enhanced T1-W sequences were available. The unidimensional maximum diameter in centimeters was used for measuring tumor size on T1-W images; median tumor size was 5.0 cm (rang 2.3 to 9.9 cm). The region of very bright T2-W signal surrounding the tumor was defined as PTE, which was estimated on the base of the maximum distance from the tumor margin to the outer edge of edema and was graded as follows [6]: minor (Figure 1A) and major (Figure 1B). According to the method of Hartmann [18], the morphological classification of PTE was performed on the base of T2-W images. Necrosis which was estimated on axial contrast-enhanced T1-W images [19] was determined when a region had high signal on T2-W images, but low signal on T1-W images, and had an irregular enhancing border on contrast-enhanced images. Cyst was defined as a rounded region which was low T1-W signal and very high T2-W signal matching cerebrospinal fluid (CSF) signal and had a thin, smooth, regular, and slightly enhancing or non-enhancing wall [10]. Contrast enhancement in tumor was grouped as no obvious (enhancement signal is less than the signal of fat) and obvious (enhancement signal is similar to that of fat). The specific classification of imaging features was listed in Table 1. According to the classification methods mentioned above, imaging data of all patients were analyzed independently by two experienced radiologists without knowledge of patient clinical information.Figure 1

Bottom Line: The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China. albert978@126.com.

ABSTRACT

Background: Magnetic resonance imaging (MRI) plays an irreplaceable role in the preoperative diagnosis of glioma, and its imaging features are the base of making treatment decisions in patients with glioma, but it is still controversial whether peritumoral edema shown by MRI from preoperative routine scans are associated with patient survival. The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.

Methods: A retrospective review of 87 patients with newly diagnosed supratentorial glioblastoma was performed using medical records and MRI data from routine scans. The Kaplan-Meier method and COX proportional hazard model were applied to evaluate the prognostic impact on overall survival of pretreatment MRI features (including peritumoral edema, edema shape, necrosis, cyst, enhancement, tumor crosses midline, edema crosses midline, and tumor size).

Results: In addition to patient age, Karnofsky performance status (KPS) and postoperative chemoradiotherapy, peritumoral edema extent and necrosis on preoperative MRI were independent prognostic indicator for poor survival. Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.

Conclusions: Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma. These features were easy to determine from routine MRI scans postoperatively and therefore could provide a certain instructive significance for clinical activities.

No MeSH data available.


Related in: MedlinePlus